Abstract
We report a case of non-ruptured popliteal aneurysms with a bleb on the right leg. A 75-year-old man was admitted with coldness and leg pain at rest. At the time of admission, emergency angiography found a right popliteal aneurysm and total arterial occlusion due to a thrombus, which extended below the knee with some collateral circulation. We started anticoagulation therapy and on the 4th hospital day we performed dissection of the popliteal aneurysm with thrombectomy, providing relief of the vasocclusion. The size of the aneurysm measured 25 mm × 40 mm with a bleb on the wall of the aneurysm. Pathologic examination of the bleb revealed an abnormal arterial structure consisting only of the tunica media. On the 4th postoperative day, a peroneal aneurysm was found by ultrasound examination. On the 13th post operative day, rupture of the peroneal aneurysm was found on emergency angiography and a covered stent was inserted. A third aneurysm was found at this time at the post tibial region, which was not treated as it did not show any tendency to increase. This weakness of blebs hold a high risk of rupture and we should resect the aneurysm as soon as a bleb is diagnosed on the aneurysm.
